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Coronary artery bypass surgery in patients with acute coronary syndromes is difficult to predict

Chew, D. P. et al.

American heart journal. VOL 155; NUMBER 5, ; 2008, 841-847 -- Elsevier Science B.V., Amsterdam (pages 841-847) -- 2008

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  • Title:
    Coronary artery bypass surgery in patients with acute coronary syndromes is difficult to predict
  • Author: Chew, D. P.;
    Mahaffey, K. W.;
    White, H. D.;
    Huang, Z.;
    Hoekstra, J. W.;
    Ferguson, J. J.;
    Califf, R. M.;
    Aylward, P. E.
  • Found In: American heart journal. VOL 155; NUMBER 5, ; 2008, 841-847
  • Journal Title: American heart journal.
  • Subjects: Medicine; Biotechnology; Pharmaceutical Chemistry; LCC: RC681; Dewey: 616.12
  • Publication Details: Elsevier Science B.V., Amsterdam
  • Language: English
  • Abstract: BackgroundAlthough the use of clopidogrel in patients “unlikelyâ€? to require coronary artery bypass grafting (CABG) is recommended in current guidelines of acute coronary syndrome (ACS) management, an important minority of patients require CABG. We assessed the ability to predict need for CABG from demographics known at the time of ACS presentation, using data from SYNERGY.MethodsPatients undergoing CABG at any time after the index angiogram were included. Early CABG was defined as surgery ResultsOf the 9053 patients undergoing angiography, 1793 (18.1%) received CABG. Early CABG (n = 972) was associated with more bleeding events (39.2% vs 29.4%, P 18 hours after cessation of enoxaparin and glycoprotein IIb/IIIa inhibition. Clinical factors associated with early CABG included diabetes and lack of prior CABG or clopidogrel. However, overall the logistic regression model had poor discriminatory ability to predict patients likely to require CABG in the setting of an ACS presentation (c-index 0.671).ConclusionsIt is difficult to predict those high-risk patients with ACS who will undergo surgical revascularization based on baseline clinical characteristics.
  • Identifier: Journal ISSN: 0002-8703
  • Publication Date: 2008
  • Physical Description: Electronic
  • Accrual Information: Monthly
  • Shelfmark(s): 0817.000000
  • UIN: ETOCRN228119554

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